Golden Livingcenter-valley Of Hayward - Hayward Nursing Home

General Information

UPDATE
Federal Provider Number
525434
Provider Name
GOLDEN LIVINGCENTER-VALLEY OF HAYWARD
Provider Address
10775 NYMAN AVE
HAYWARD, WI 54843
Provider Phone Number
(715) 634-2202
Provider SSA County
560
Provider County Name
Sawyer
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BEVERLY ENTERPRISES - WISCONSIN INC
Date First Approved to Provide Medicare and Medicaid services
1989-09-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.02750
Reported LPN Staffing Hours per Resident per Day
0.27375
Reported RN Staffing Hours per Resident per Day
1.18125
Reported Licensed Staffing Hours per Resident per Day
1.45500
Reported Total Nurse Staffing Hours per Resident per Day
3.48250
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14625
Expected CNA Staffing Hours per Resident per Day
2.51061
Expected LPN Staffing Hours per Resident per Day
0.60810
Expected RN Staffing Hours per Resident per Day
1.04148
Expected Total Nurse Staffing Hours per Resident per Day
4.16019
Adjusted CNA Staffing Hours per Resident per Day
1.98154
Adjusted LPN Staffing Hours per Resident per Day
0.37364
Adjusted RN Staffing Hours per Resident per Day
0.84748
Adjusted Total Nurse Staffing Hours per Resident per Day
3.37427
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2014-01-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-11-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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